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I <br /> SUNNY rs4F <br /> j. <br /> r-• - ,), ; , <br /> u NON - COLLUSION AFFIDAVIT <br /> z <br /> 44.'• : City of Sunny Isles Beach <br /> t.; t.-----' �• 18070 Collins Avenue <br /> �F�D''•r oP`°o+`' Sunny Isles Beach,FL 33160 <br /> ''or sus '� Telephone:(305)947-0606 Fax:(305)949-3113 <br /> STATE OF FLORIDA ) <br /> COUNTY OF Jefferson Parish) ) <br /> The undersigned being first duly sworn as provided by law,deposes,and says: <br /> This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be <br /> relied upon by said County,in any consideration which may give to and any action it may take with respect to this RFP. <br /> The undersigned is authorized to make this Affidavit on behalf of, <br /> DRC Emergency Services, LLC <br /> (Name of Corporation,Partnership,Individual,etc.) <br /> a, Limited Liability Company formed under the laws of Alabama <br /> (Type of Business) (State) <br /> I <br /> of which he is Vice President/SecretaryfTreasurer <br /> (Sole Owner, Partner,President,etc.) <br /> Neither the undersigned nor any person, firm, or corporation named above nor anyone else to the knowledge of the undersigned, have <br /> I themselves solicited or employed anyone else to solicit favorable action for this RFP by the City, also that no head of any department <br /> or employee therein,or any officer of the City of Sunny Isles Beach,Florida is directly interested therein. <br /> This RFP is genuine and not collusive or a sham; the person, firm or corporation named above has not colluded, conspired, connived or <br /> agreed directly or indirectly with any proposers or person, firm or corporation, to put in a sham RFP, or that such person, firm or <br /> corporation, shall refrain from Bidding,and has not in any manner,directly or indirectly, sought by agreement or collusion,or communication <br /> or conference with any person, firm or corporation, to fix the prices of said Bid or Bids of any other proposers; and all statements <br /> contained in the RFP or RFP's described above true; and further; neither the undersigned, nor the person, firm or corporation named <br /> above has directly or indirectly submitted said RFP or the contents thereof, or divulg-: information ori elative thereto, to any <br /> I association or to any member or agent thereof. <br /> / I <br /> Kristy Fuentes Vice President/Secr-ta reasur <br /> IAFFIANT'S NAME AFFIANT'S TITLE <br /> 1 TAKEN,SWORN AND SUBSCRIBED TO BEFORE ME this v day of ,2018. <br /> Personally Kno n or Produced Identification <br /> C <br /> Type of identification <br /> I (Affix seal here) 1(1 <br /> IGARY A. DES ROCHES • 7"'Y PUBLIC(name printed or typed) <br /> NOTARY PUBLIC <br /> State of Louisiana, Bar No. 19550 <br /> IMy Commission is for life <br /> - <br /> 1of10 <br /> I 115 <br />